HomeMy WebLinkAboutREVISION - BUILDING PERMIT - 10-30-18OFFICE USE ONLY:
I 2 I
DATE �ILED: 1 Q J - 0 - 19
REVISION FEE:
LOCATION/SITE
ADDRESS: / 3�
PERMIT #
RECEIPT # ( a
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION RECEIVED
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772) 462.1553 O C T 3 0 '' U 1 a
APPLICATION FOR BUILDING PERMIT REVISIONSL Lucie county, Permitting - _
PROJECT INFORMATION
/t)w
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: G 1 T. LUCIE CO CE T. #:
BUSINESS NAME: 5JM S754a y�o21
QUALIFIERS NAME: P v
ADDRESS- A
CITY: % G STATE: L ZIP:
PHONE (DAYTIME): Z - 2 FAX:
_O WNER/BUILD�E,R,, IINFORM/ATION:
NAME: �''/ '�'l �r�,5 / e
ADDRESS: Ov
CITY: 006A WAIVA-) STATE:
ARCHITECT/ENGINEER INFORMATION:
NAME•
ADDRESS:
CITY:
PHONE (D,
SCANNED
BY
.8t Lucie County
c
SLCCC: 9123109
Revised 06130117
EVISION